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Artificial Rectum for Suppository Administration

  Submitted by: Terri Kirkland on June 28, 2018
  HomeGrown Solution Number: 299
Identification of the Problem
How to provide students with the sensation and psycho-motor skills of administering a suppository without a live patient.
Unique Idea
Create an artificial “rectum” that simulates the feel and psycho-motor skills of inserting a suppository. Found that gelatin as described below provides the pressure against the finger to simulate a rectal sphincter.
Objectives
Create an artificial “rectum” that can be used by more than one student to replicate the feel and psycho-motor skill of inserting a suppository. Provide immediate feedback that the student has inserted the suppository to the correct depth by observing “stool” (chocolate pudding) on the gloved finger when it is withdrawn.
Supplies/Ingredients
1. Four-ounce clear specimen cups with lids
2. Instant chocolate pudding-one package
3. Whole milk
4. Half and half cream
5. Gelatin, preferably peach flavored
6. Green food coloring
7. Non-sterile gloves
8. Lubricating jelly packet
9. Suppository
Steps to Creating the Solution
1. Mix one box of instant chocolate pudding with 2 cups of whole milk according to the instruction on the box. (The higher fat content of the whole milk provides a firmer consistency to the pudding. I tried to use water to reduce the cost, but it does not work because the pudding never sets.)
2. Pour the pudding into the specimen cups to the 60 ml level. This provides enough depth to accommodate the suppositories. One box of pudding mix will fill approximately six specimen cups up to the 60 ml level. Be sure to clean up any drips along the rim and top to avoid it mixing with the gelatin. Refrigerate until set and firm.
3. Pour two packages of peach flavored gelatin into a bowl and add one cup of boiling water. Mix until well dissolved. Allow to cool to near room temperature, but do not allow to set up. Add one-quarter cup plus two tablespoons of half-and-half. The fat in the half-and-half will turn the gelatin opaque. Add one drop of green food coloring. Any color of gelatin may be used, but if a more flesh-like appearance is desired, use the above formula. Make the gelatin according to the “fun-shapes” or “wiggle jiggle” recipe on the box.
4. Fill the specimen cup to the four-ounce marking (up to but not over the area of the threads to where the lid screws on). Do not overfill or the surface will be imprinted with the underside of the lid and will not be smooth. The mixture will top off six to eight specimen cups.
5. Apply the specimen cup lids and refrigerate until firm.
6. When firm and before using, cut a single slice into the surface of the gelatin. Be sure to penetrate through the gelatin layer into the pudding layer. Do not cut to the edge of the container, but leave approximately ¼ to ½ intact at each edge. Be sure to clean the knife between containers to prevent contaminating the surface of the gelatin with pudding when cutting into the next container.
7. Specimen containers are best because they are easily sealed, do not spill and can be stacked in the refrigerator to save space. “Rectums” can be refrigerated for several weeks. Each “rectum” will hold up to three suppositories, but two insertions seemed to work best.
8. To use: Have the student apply non-sterile gloves and open the suppository, the specimen cup and the lubricating jelly package. Have the student hold the specimen cup in their non-dominant hand to simulate holding the buttocks cheeks apart. Have the student lubricate the suppository with the lubricating jelly and insert the suppository using one finger into the “rectum”. If the suppository is correctly inserted past the gelatin “sphincter” then they will have pudding on their finger when it is withdrawn. Do not attempt to withdraw the suppository.
9. Video at: https://www.youtube.com/watch?v=Lf0CLuClaMs